Heart valve disease, and particularly aortic heart valve disease, has been a medical problem for many years. Over time, natural aortic valves may leak, causing aortic insufficiency or regurgitation, or may become blocked or exhibit limited function due to aortic stenosis. Early heart disease treatments included insertion of either a mechanical or prosthetic valve through a median sternotomy and open heart surgery.
Although improvements to open heart surgery have been made over the years, resulting in a significant lessening of mortality and morbidity rates, open heart surgery still remains a very involved and complicated undertaking. Moreover, post-operative recovery is often lengthy. Efforts therefore continue to develop non-surgical techniques for managing heart valve disease.
One such non-surgical technique involves percutaneous aortic valve replacement. With this technique, a valve is transported to the heart via, for example, the femoral vein through a small incision made in the groin. However, no matter how successful, this technique also exhibits limitations. For example, the path from the groin to the aortic valve via the femoral vein is relatively lengthy and requires crossing of the mitral valve. Crossing of the mitral valve can itself induce mitral insufficiency and reduced cardiac output.
More recently, surgeons have been opting for a transapical approach to aortic valve replacement. Under this approach, surgeons reach the native aortic valve with a catheter pre-loaded with a replacement valve. Generally, the catheter and valve assembly are placed through the apex of the heart in an antegrade approach. With this technique, precise and exact positioning of the replacement valve is required. Heretofore, surgeons manipulated the catheter delivery device exclusively by hand. However, it would be advantageous to assist with the process by providing both stability for the catheter delivery device and a reference datum for the surgeon. It would also be beneficial to provide novel surgical methods for taking advantage of such a fixed reference mechanism.